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A Practice Change to Eliminate Prophylactic Antibiotics for Elective Percutaneous Nephrostomy Tube Exchanges in Low-Risk Outpatients: A Retrospective Review on Risk for Infection

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Journal of Radiology Nursing 2019年第4期38卷 241-249页

作者： Brick, Jamie Michele Dail, Robin B. Priode, Kimberly Wirth, Michael Yamada, Ricardo University of South Carolina College of Nursing Columbia SC United States Associate Dean for Faculty Affairs and Professor University of South Carolina College of Nursing Columbia SC United States Clinical Assistant Professor University of South Carolina College of Nursing Columbia SC United States Research Assistant Professor College of Nursing and Department of Epidemiology and Biostatistics Cancer Prevention and Control Program University of South Carolina Columbia SC United States Assistant Professor Vascular and Interventional Radiology Medical University of South Carolina Charleston SC United States

The purpose of this project was to determine if evidence-based practice change related to antibiotic administration criteria for outpatients receiving percutaneous nephrostomy tube exchanges implemented by a medical center's Vascular and Interventional Radiology department impacted hospital admission rates for infection in these patients. The 2017 practice change was based on 2010 guidelines from the Society of Interventional Radiology (SIR), stating that outpatients with a low risk of acquiring infection did not need to receive a perioperative antibiotic, as evidence has shown prophylactic therapy has no significant effect on infection rates for this population. Using a retrospective review design, 1 year of data before and after the practice change were collected and analyzed using the repeated measures generalized estimating equation (GEE) model with a binomial output by Liang & Zeger. Fisher's exact test was used to evaluate demographic variables by level of risk of infection. Data included 493 procedural events for 126 outpatients. The mean number of events per patient was 3.91 (SD: 4.15;median: 2;interquartile range: 3). Admission and infection criteria within thirty days of the event and infection risk factors were collected for each patient. Age, sex, and race were the variables that had a significant relationship with risk level of infection. Due to sample size, the GEE model could not be run using risk level (high/low) to predict admissions before or after the practice change. The relationship between the number of risk factors (0-5) and the odds of admission for infection was the same regardless of the practice change (before: odds ratio [OR] = 2.17, 95% confidence interval [CI] = 1.19-3.95;after: OR = 1.9, 95% CI = 1.12-3.22, p_interaction =. 67). For every increase in a patient's number of risk factors, the odds of developing an infection would be expected to increase by almost 90% (OR = 1.9, 95% CI = 1.27-2.84). Although it was not possible t

关键词： Antibiotic stewardship Infection Interventional radiology Percutaneous nephrostomy Practice change

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Discovery of an Inherited Variant Associated with Susceptibility to Secondary Acute Lymphoblastic Leukemia (ALL) after Lenalidomide Maintenance and Autologous HCT for Multiple Myeloma (MM)

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Transplantation and Cellular Therapy 2024年第2期30卷 S99-S100页

作者： Zhu, Qianqian, PhD Herr, Megan, PhD Liang, Shuyi Hu, Qiang, MD, PhD Singh, Prashant K, PhD Gao, Xinyu Pasquini, Marcelo C. Leonard, Jessica T., MD Rosko, Ashley, MD Bayer, Ruthee-Lu, MD Krishnan, Amrita, MD Stadtmauer, Edward A., MD Maziarz, Richard T., MD McCarthy, Phillip L, MD Hahn, Theresa E., PhD Biostatistics & Bioinformatics Roswell Park Comprehensive Cancer Center Buffalo NY Department of Medicine Roswell Park Comprehensive Cancer Center Buffalo NY Cancer Genetics & Genomics Roswell Park Comprehensive Cancer Center Buffalo NY Center for International Blood and Marrow Transplant Research Medical College of Wisconsin Milwaukee WI Center for Hematologic Malignancies - Knight Cancer Institute Oregon Health & Science University Portland OR The Ohio State University Columbus OH Hematology/Oncology North Shore University Hospital Northwell Health Lake Success NY City of Hope Duarte CA Blood and Marrow Transplantation Program Abramson Cancer Center and the Division of Hematology and Oncology Hospital of the University of Pennsylvania Philadelphia PA Cancer Prevention & Control Roswell Park Comprehensive Cancer Center Buffalo NY

An increased risk of ALL second primary malignancy (SPM) has been observed with lenalidomide maintenance therapy after autologous HCT (len-post-autoHCT) for MM. Lenalidomide exerts its therapeutic effects via cereblon-mediated downregulation of the transcription factors Ikaros ( IKZF1) and Aiolos ( IKZF3). Inherited susceptibility variants in IKZF1 have been described for de novo ALL. We performed a case-control germline targeted sequencing study of the entire IKZF1 and IKZF3 genes with mean coverage ∼2,200X to investigate inherited susceptibility to ALL SPM risk. All cases and controls had a primary diagnosis of MM and received len-post-autoHCT with melphalan; sequencing was performed on an aliquot of the apheresis product or peripheral blood sample that was collected before autoHCT for MM. Cases of ALL SPMs were contributed by 4 individual centers and one national trial (BMT CTN 0702); each case had a maximum of 4 controls per case, sampled with replacement and matched on age, sex, race/ethnicity and duration of lenalidomide exposure (controls had longer duration of lenalidomide maintenance than cases). An additional control group of Acute Myeloid Leukemia/Myelodysplastic Syndrome (AML/MDS) SPMs after len-post-autoHCT were contributed by one center (Table). Multivariate logistic regression of case-control status, adjusted by age at HCT, sex, race/ethnicity, duration of lenalidomide maintenance, was performed for: 1) ALL SPM, 2) AML/MDS SPM, 3) ALL and AML/MDS SPM. We found the risk allele A of rs62447181 in IKZF1 had an OR=2.51 P=9.53 × 10 −3 for ALL SPM, OR=4.18 P=0.09 for AML/MDS SPM and OR=2.57 P=4.98 × 10 −3 for ALL&AML/MDS SPM. rs62447181 is a cis-expression quantitative trait loci (eQTL) of IKZF1 in blood (p=3.88 × 10 −55 in eQTLGen Consortium data) and resides in a promoter-proximal enhancer predicted by the ENCODE project (Figure A). Our in silico analysis of transcription factor binding sites showed that rs62447181 disrupts the binding site of PLAGL2, a k

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Artificial intelligence for geoscience:Progress,challenges,and perspectives

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The Innovation 2024年第5期5卷 136-160,135页

作者： Tianjie Zhao Sheng Wang Chaojun Ouyang Min Chen Chenying Liu Jin Zhang Long Yu Fei Wang Yong Xie Jun Li Fang Wang Sabine Grunwald Bryan MWong Fan Zhang Zhen Qian Yongjun Xu Chengqing Yu Wei Han Tao Sun Zezhi Shao Tangwen Qian Zhao Chen Jiangyuan Zeng Huai Zhang Husi Letu Bing Zhang Li Wang Lei Luo Chong Shi Hongjun Su Hongsheng Zhang Shuai Yin Ni Huang Wei Zhao Nan Li Chaolei Zheng Yang Zhou Changping Huang Defeng Feng Qingsong Xu Yan Wu Danfeng Hong Zhenyu Wang Yinyi Lin Tangtang Zhang Prashant Kumar Antonio Plaza Jocelyn Chanussot Jiabao Zhang Jiancheng Shi Lizhe Wang Aerospace Information Research Institute Chinese Academy of SciencesBeijing 100094China School of Computer Science China University of GeosciencesWuhan 430078China State Key Laboratory of Mountain Hazards and Engineering Resilience Institute of Mountain Hazards and EnvironmentChinese Academy of SciencesChengdu 610299China Key Laboratory of Virtual Geographic Environment(Ministry of Education of PRC) Nanjing Normal UniversityNanjing 210023China Data Science in Earth Observation Technical University of Munich80333 MunichGermany The National Key Laboratory of Water Disaster Prevention Yangtze Institute for Conservation and DevelopmentHohai UniversityNanjing 210098China Institute of Computing Technology Chinese Academy of SciencesBeijing 100190China School of Geographical Sciences Nanjing University of Information Science and TechnologyNanjing 210044China State Key Laboratory of Soil and Sustainable Agriculture Institute of Soil ScienceChinese Academy of SciencesNanjing 210008China Soil Water and Ecosystem Sciences DepartmentUniversity of FloridaPO Box 110290GainesvilleFLUSA Materials Science Engineering Program Cooperating Faculty Member in the Department of Chemistry and Department of Physics Astronomy University of CaliforniaCaliforniaRiversideCA 92521USA Institute of Remote Sensing and Geographical Information System School of Earth and Space SciencesPeking UniversityBeijing 100871China Key Laboratory of Computational Geodynamics University of Chinese Academy of SciencesBeijing 100049China International Research Center of Big Data for Sustainable Development Goals Beijing 100094China College of Geography and Remote Sensing Hohai UniversityNanjing 211100China Department of Geography The University of Hong KongHong Kong 999077SARChina Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control Nanjing 210044China School of Environmental Science and Engineering Nanjing University of Information Science&TechnologyNanjing 210044China Collaborative Inno

This paper explores the evolution of geoscientific inquiry,tracing the progression from traditional physics-based models to modern data-driven approaches facilitated by significant advancements in artificial intelligence(AI)and data collection *** models,which are grounded in physical and numerical frameworks,provide robust explanations by explicitly reconstructing underlying physical ***,their limitations in comprehensively capturing Earth’s complexities and uncertainties pose challenges in optimization and real-world *** contrast,contemporary data-driven models,particularly those utilizing machine learning(ML)and deep learning(DL),leverage extensive geoscience data to glean insights without requiring exhaustive theoretical *** techniques have shown promise in addressing Earth science-related ***,challenges such as data scarcity,computational demands,data privacy concerns,and the“black-box”nature of AI models hinder their seamless integration into *** integration of physics-based and data-driven methodologies into hybrid models presents an alternative *** models,which incorporate domain knowledge to guide AI methodologies,demonstrate enhanced efficiency and performance with reduced training data *** review provides a comprehensive overview of geoscientific research paradigms,emphasizing untapped opportunities at the intersection of advanced AI techniques and *** examines major methodologies,showcases advances in large-scale models,and discusses the challenges and prospects that will shape the future landscape of AI in *** paper outlines a dynamic field ripe with possibilities,poised to unlock new understandings of Earth’s complexities and further advance geoscience exploration.

关键词： Earth utilizing landscape

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Molecular evidence for new sympatric cryptic species of Aedes albopictus(Diptera: Culicidae) in China: A new threat from Aedes albopictus subgroup?

Molecular evidence for new sympatric cryptic species of Aede...

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第六届国际蚊虫及虫媒病监测和防治学术研讨会暨第十二届全国医学昆虫学学术讨论会

作者： Yuyan Guo Zhangyao Song Lei Luo Qingmin Wang Guofa Zhou Dizi Yang Daibin Zhong Xueli Zheng Department of Pathogen Biology School of Public Health Southern Medical University Department of Disinfection and Pesticide of Center for Disease Control and Prevention of Guangzhou Department of Epidemiology and Health Statistics School of Public Health Guizhou Medical University Program in Public Health School of Medicine University of California

Background: Aedes(Stegomyia) albopictus(Skuse) is an indigenous species and the predominant vector of dengue fever in China. Understanding of genetic diversity and structure of the mosquito would facilitate dengue prevention and vector control. Sympatric cryptic species have been identified in the Ae. albopictus subgroup in Southeast Asia;however, little is known about the presence and distribution of cryptic species in China. This study aimed to examine the genetic diversity, evaluate potential new cryptic sibling species, and assess the prevalence of Wolbachia infections in field populations. Methods: Aedes adult female specimens were collected from five provinces in southern and central China during 2015–2016. Morphological identification was performed under dissection microscope. The mitochondrial DNA cytochrome c oxidase subunit 1(cox1, DNA barcoding) locus and the ribosomal DNA internal transcribed spacer region 2(ITS2) marker were used to examine the genetic variation, evaluate cryptic sibling species, and population structure in the field populations. Screening for the presence of Wolbachia was performed using multiplex PCR. Results: A total of 140 individual specimens with morphological characteristics similar to Ae. albopictus were sequenced for DNA barcoding. Among these, 129 specimens(92.1%) were confirmed and identified as Ae. albopictus. The remaining 11 specimens, from 2 provinces,were identified as 2 distinct sequence groups, which were confirmed by ITS2 marker sequencing, suggesting the existence of potential cryptic species of Ae. albopictus. In Ae. albopictus, we found significant genetic differentiation and population structure between populations collected from different climate zones. Medium to high frequencies of Wolbachia infections were observed in natural Ae. albopictus populations, whereas Wolbachia was infrequent or absent in cryptic species populations. Conclusions: Our findings highlight the population differentiation by climate zone an

关键词： in China A new threat from Aedes albopictus subgroup Culicidae Diptera Molecular evidence for new sympatric cryptic species of Aedes albopictus

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Emerging contaminants:A One Health perspective

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The Innovation 2024年第4期5卷 140-170,139页

作者： Fang Wang Leilei Xiang Kelvin Sze-Yin Leung Martin Elsner Ying Zhang Yuming Guo Bo Pan Hongwen Sun Taicheng An Guangguo Ying Bryan WBrooks Deyi Hou Damian EHelbling Jianqiang Sun Hao Qiu Timothy MVogel Wei Zhang Yanzheng Gao Myrna JSimpson Yi Luo Scott XChang Guanyong Su Bryan MWong Tzung-May Fu Dong Zhu Karl JJobst Chengjun Ge Frederic Coulon Jean Damascene Harindintwali Xiankui Zeng Haijun Wang Yuhao Fu Zhong Wei Rainer Lohmann Changer Chen Yang Song Concepcion Sanchez-Cid Yu Wang Ali El-Naggar Yiming Yao Yanran Huang Japhet Cheuk-Fung Law Chenggang Gu Huizhong Shen Yanpeng Gao Chao Qin Hao Li Tong Zhang Natàlia Corcoll Min Liu Daniel SAlessi Hui Li Kristian KBrandt Yolanda Pico Cheng Gu Jianhua Guo Jianqiang Su Philippe Corvini Mao Ye Teresa Rocha-Santos Huan He Yi Yang Meiping Tong Weina Zhang Fidèle Suanon Ferdi Brahushi Zhenyu Wang Syed AHashsham Marko Virta Qingbin Yuan Gaofei Jiang Louis A.Tremblay Qingwei Bu Jichun Wu Willie Peijnenburg Edward Topp Xinde Cao Xin Jiang Minghui Zheng Taolin Zhang Yongming Luo Lizhong Zhu Xiangdong Li DamiàBarceló Jianmin Chen Baoshan Xing Wulf Amelung Zongwei Cai Ravi Naidu Qirong Shen Janusz Pawliszyn Yong-guan Zhu Andreas Schaeffer Matthias C.Rillig Fengchang Wu Gang Yu James M.Tiedje State Key Laboratory of Soil and Sustainable Agriculture Institute of Soil ScienceChinese Academy of SciencesNanjing 210008China University of Chinese Academy of Sciences Beijing 100049China Department of Chemistry Hong Kong Baptist UniversityHong KongChina HKBU Institute of Research and Continuing Education Shenzhen Virtual University ParkShenzhenChina Technical University of Munich TUM School of Natural SciencesInstitute of Hydrochemistry85748 GarchingGermany School of Resources&Environment Northeast Agricultural UniversityHarbin 150030China Climate Air Quality Research UnitSchool of Public Health and Preventive MedicineMonash UniversityMelbourneVICAustralia Faculty of Environmental Science&Engineering Kunming University of Science&TechnologyKunming 650500China Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria College of Environmental Science and EngineeringNankai UniversityTianjin 300350China Guangdong Key Laboratory of Environmental Catalysis and Health Risk Control School of Environmental Science and EngineeringInstitute of Environmental Health and Pollution ControlGuangdong University of TechnologyGuangzhou 510006China Ministry of Education Key Laboratory of Environmental Theoretical Chemistry South China Normal UniversityGuangzhouGuangdong 510006China Department of Environmental Science Baylor UniversityWacoTXUSA Center for Reservoir and Aquatic Systems Research(CRASR) Baylor UniversityWacoTXUSA School of Environment Tsinghua UniversityBeijing 100084China School of Civil and Environmental Engineering Cornell UniversityIthacaNY 14853USA Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province Zhejiang University of TechnologyHangzhou 310014China School of Environmental Science and Engineering Shanghai Jiao Tong UniversityShanghai 200240China Laboratoire d’Ecologie Microbienne Universite Claude Bernard Lyon 1UMR CNRS 5557UMR INRAE 1418VetAgro Sup69622 VilleurbanneFrance Department of Pla

Environmental pollution is escalating due to rapid global development that often prioritizes human needs over planetary *** global efforts to mitigate legacy pollutants,the continuous introduction of new substances remains a major threat to both people and the *** response,global initiatives are focusing on risk assessment and regulation of emerging contaminants,as demonstrated by the ongoing efforts to establish the UN’s Intergovernmental Science-Policy Panel on Chemicals,Waste,and Pollution *** review identifies the sources and impacts of emerging contaminants on planetary health,emphasizing the importance of adopting a One Health *** for monitoring and addressing these pollutants are discussed,underscoring the need for robust and socially equitable environmental policies at both regional and international *** actions are needed to transition toward sustainable pollution management practices to safeguard our planet for future generations.

关键词： pollution planet contaminants

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Correction to: The dietary inflammatory index is associated with anti and pro‑inflammatory adipokines in Brazilian schoolchildren

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European journal of nutrition 2021年第5期60卷 2851-2853页

作者： Lara Gomes Suhett H H M Hermsdorff Sarah Aparecida Vieira Ribeiro Mariana De Santis Filgueiras Nitin Shivappa James R Hébert Juliana Farias de Novaes Department of Nutrition and Health Universidade Federal de Viçosa (UFV) Av. P.H. Rolfs s/n Campus Universitário Viçosa Minas Gerais 36570-000 Brazil. nutrilarasuhett@***. Department of Nutrition and Health Universidade Federal de Viçosa (UFV) Av. P.H. Rolfs s/n Campus Universitário Viçosa Minas Gerais 36570-000 Brazil. Department of Epidemiology and Biostatistics Arnold School of Public Health University of South Carolina Columbia SC USA. Statewide Cancer Prevention and Control Program (CPCP) Arnold School of Public Health University of South Carolina 915 Greene Street Columbia SC 29208 USA. Department of Nutrition Connecting Health Innovations (CHI) 1417 Gregg Street Columbia SC 29201 USA.

A correction to this paper has been published: https://***/10.1007/s00394-021-02544-w

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Randomized trial of a community-based, culturally tailored intervention: High engagement among Latina breast cancer survivors

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Cancer 2025年第11期131卷 e35842页

作者： AuBuchon, Katarina E. Galván, Claudia J. Campos Duron, Ysabel Sampayo, Ivis Torres, Migdalia Hurtado-de-Mendoza, Alejandra Kuo, Charlene Rush, Christina Elliott, Maria Gloria Santiago, Jennie Cepeda, Olympia Logie, Laura A. Jimenez, Astrid Luta, George Graves, Kristi D. Cancer Prevention and Control Program Department of Oncology Lombardi Comprehensive Cancer Center Georgetown University Washington DC United States Community Outreach and Engagement George Washington University Washington DC United States Latino Cancer Institute San Jose CA United States LatinaSHARE New York NY United States Red Door Community (formerly Gilda’s Club New York City) New York NY United States Department of Behavioral and Community Health School of Public Health University of Maryland Baltimore MD United States Department of Psychiatry Massachusetts General Hospital Center for Health Outcomes and Interdisciplinary Research Harvard University Boston MA United States Nueva Vida Inc Alexandria VA United States Department of Biostatistics Bioinformatics and Biomathematics Georgetown University Washington DC United States

Background: A preliminary randomized controlled trial was conducted to evaluate the impact of a culturally tailored, group-based intervention for Latina breast cancer survivors (BCSs) and their caregivers on survivors’ quality of life (QOL) compared to usual care services provided by community-based organizations. Methods: This study randomized 136 Latina BCSs and 136 caregivers in Washington, DC;New York, New York;and San Jose, California to an eight-session culturally tailored coping and communication intervention (n = 70 dyads) or usual care support services via community-based organizations (n = 66 dyads). QOL domains (anxiety, depression, fatigue, physical functioning, and social functioning) were measured at baseline, immediately post-intervention, and 6 months post-intervention. Results: Among the 70 dyads in the intervention, 71.4% (n = 50) attended five or more of the eight sessions, which demonstrated high engagement;82% of participants were retained at 6 months. Results indicated clinically significant improvements in Latina BCSs’ reports of anxiety and fatigue at 6 months postintervention compared to BCSs in usual care;however, after adjustment for multiple comparisons, results were not statistically significant. Conclusions: A culturally tailored, group-based intervention for Latina BCSs and their caregivers led to clinically relevant but not statistically significant improvements in survivors’ anxiety and fatigue compared to usual services provided by community-based organizations. Interventions conducted in partnership with community-based organizations yield high engagement and retention;these types of collaborative approaches to psychosocial services have the potential to positively affect Latina BCSs’ QOL. © 2025 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.

关键词： breast cancer caregiving community-based research intervention Latina survivorship

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Potential complications of monkeypox

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The Lancet. Neurology 2022年第10期21卷 872页

作者： B Jeanne Billioux Oliver Tshiani Mbaya James Sejvar Avindra Nath National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda MA 20892 USA. Institut National de Recherche Biomédicale Kinshasa Democratic Republic of Congo Clinical Monitoring Research Program Directorate Frederick National Laboratory for Cancer Research Frederick MD USA. National Institute of Neurological Disorders and Stroke National Institutes of Health Bethesda MA 20892 USA Centers for Disease Control and Prevention Atlanta GA USA. Electronic address: avindra.nath@nih.gov.

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Correction to: Zoonotic Disease Exposure Risk and Rabies Vaccination Among Wildlife Professionals

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EcoHealth 2020年第1期17卷 84页

作者： Sheena Tarrant Jessie Grewal Hayley Yaglom Elisabeth Lawaczeck Heather Venkat Centers for Disease Control and Prevention Arizona Department of Health Services 150 N 18th Ave Suite 140 Phoenix AZ 85007 USA. Centers for Disease Control and Prevention Arizona Department of Health Services 150 N 18th Ave Suite 140 Phoenix AZ 85007 USA. hvenkat@cdc.gov. Career Epidemiology Field Officer Program Center for Preparedness and Response Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta GA 30333 USA. hvenkat@cdc.gov.

The original version of the article unfortunately contained a typo error in second author name in the author group. The author name was incorrectly published as "Jesse Grewal" and the correct name is "J...

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Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment

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The Lancet 2021年第10302期398卷 772-785页

作者： Hug, Lucia You, Danzhen Blencowe, Hannah Mishra, Anu Wang, Zhengfan Fix, Miranda J Wakefield, Jon Moran, Allisyn C Gaigbe-Togbe, Victor Suzuki, Emi Blau, Dianna M Cousens, Simon Creanga, Andreea Croft, Trevor Hill, Kenneth Joseph, K.S. Maswime, Salome McClure, Elizabeth M Pattinson, Robert Pedersen, Jon Smith, Lucy K Zeitlin, Jennifer Alkema, Leontine Division of Data Analytics Planning and Monitoring UNICEF New York NY United States Maternal Adolescent Reproductive & Child Health Centre London School of Hygiene & Tropical Medicine London UK United Kingdom Department of Biostatistics and Epidemiology University of Massachusetts Amherst Amherst MA United States University of Washington Seattle WA United States Department of Maternal Newborn Child and Adolescent Health WHO Geneva Switzerland UN Population Division New York NY United States Development Data Group World Bank Washington DC United States Centers for Disease Control and Prevention Atlanta GA United States Johns Hopkins University Baltimore MD United States The Demographic and Health Surveys Program ICF Rockville MD United States Stanton-Hill Research Moultonborough NH United States University of British Columbia Vancouver BC Canada Children's and Women's Hospital and Health Centre of British Columbia Vancouver BC Canada University of Cape Town Cape Town South Africa RTI International Research Triangle Park NC United States SAMRC/UP Maternal and Infant Health Care Strategies Unit Department of Obstetrics and Gynaecology University of Pretoria Pretoria South Africa Mikro Oslo Norway Department of Health Sciences University of Leicester Leicester United Kingdom Inserm UMR 1153 Obstetrical Perinatal and Pediatric Epidemiology Research Team Center for Epidemiology and Statistics Sorbonne Paris Cité DHU Risks in Pregnancy Paris Descartes University Paris France

Background: Stillbirths are a major public health issue and a sensitive marker of the quality of care around pregnancy and birth. The UN Global Strategy for Women's, Children's and Adolescents’ Health (2016–30) and the Every Newborn Action Plan (led by UNICEF and WHO) call for an end to preventable stillbirths. A first step to prevent stillbirths is obtaining standardised measurement of stillbirth rates across countries. We estimated stillbirth rates and their trends for 195 countries from 2000 to 2019 and assessed progress over time. Methods: For a systematic assessment, we created a dataset of 2833 country-year datapoints from 171 countries relevant to stillbirth rates, including data from registration and health information systems, household-based surveys, and population-based studies. After data quality assessment and exclusions, we used 1531 datapoints to estimate country-specific stillbirth rates for 195 countries from 2000 to 2019 using a Bayesian hierarchical temporal sparse regression model, according to a definition of stillbirth of at least 28 weeks’ gestational age. Our model combined covariates with a temporal smoothing process such that estimates were informed by data for country-periods with high quality data, while being based on covariates for country-periods with little or no data on stillbirth rates. Bias and additional uncertainty associated with observations based on alternative stillbirth definitions and source types, and observations that were subject to non-sampling errors, were included in the model. We compared the estimated stillbirth rates and trends to previously reported mortality estimates in children younger than 5 years. Findings: Globally in 2019, an estimated 2·0 million babies (90% uncertainty interval [UI] 1·9–2·2) were stillborn at 28 weeks or more of gestation, with a global stillbirth rate of 13·9 stillbirths (90% UI 13·5–15·4) per 1000 total births. Stillbirth rates in 2019 varied widely across regions, from 22·8 stillbirths

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